implantable cardiac defibrillator and bi-ventricular pacing

Your heart has a natural pacemaker called the sino-atrial node (SA node). The SA node helps your heart maintain a normal rhythm and sends an electrical impulse beginning in one of the upper chambers (right or left atrium) of the heart. This impulse continues through your heart to the lower chambers (right and left ventricles). This process provides normal blood flow through the body (peripherally). Life-threatening heart arrhythmias occur when a pathway becomes blocked.

Bon Secours Heart & Vascular Institute offers various cardiac rhythm interventions through insertion of biventricular pacemakers and implantable converter defibrillators (ICDs). These devices convert the arrhythmias to normal cardiac rhythm and assist the heart to function normally.

what is biventricular pacing?

Biventricular pacemakers are implantable devices used to synchronize the beating of the two ventricles of the heart. In a healthy beating heart, both lower chambers of the heart (ventricles) beat together. The biventricular pacemaker is extremely useful when congestive heart failure occurs. In congestive heart failure, the weakened ventricles are enlarged and no longer beat together. Implanting the biventricular pacemaker is called cardiac resynchronization therapy because this pacemaker is used to re-synchronize the rhythm of the ventricles. Many research studies have shown that cardiac resynchronization improves heart function, reduces symptoms, and prolongs life in patients with heart failure. Patients with congestive heart failure may have abnormalities in the electrical conduction system of the heart that can lead to sudden cardiac death. Thus, biventricular pacemakers can be combined with implantable cardioverter defibrillators (IDSs) for patients at risk for life-threatening arrhythmias.

how is biventricular pacemaker implanted?

Most biventricular pacemakers are inserted under the skin of the chest. These pacemakers consist of “wires” or “leads” as they are called and are inserted in a vein in the shoulder or beneath the collar bone under x-ray guidance. These leads are advanced into the heart through visualization by means of the x-ray guidance to prevent any incorrect placement. One lead is positioned into a vein the heart which lies over the left ventricle while the second lead is placed in the right ventricle. By placing a lead in each ventricle, the ventricles are re-synchronized to beat simultaneously. The leads permit the device to detect heart rhythm and to deliver the proper therapy, if necessary, to re-synchronize the heart to normal rhythm.

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